PMID- 38435144
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240305
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 16
IP  - 2
DP  - 2024 Feb
TI  - Atypical Clostridium difficile Infection in a Pregnant Patient: A Case Study on 
      Non-Diarrheal Presentation and Syndrome of Inappropriate Antidiuretic Hormone 
      (SIADH) Complication.
PG  - e53449
LID - 10.7759/cureus.53449 [doi]
LID - e53449
AB  - Clostridium difficile (C. difficile) is a Gram-positive, spore-producing 
      bacterium that often leads to pseudomembranous colitis, typically manifesting as 
      watery diarrhea. The risk factors for C. difficile infection (CDI) include 
      exposure to broad-spectrum antibiotics, immunocompromised states, advanced age, 
      usage of proton pump inhibitors (PPI), and comorbid conditions such as chronic 
      kidney disease (CKD). This report details a case involving a 23-year-old pregnant 
      woman who presented with symptoms of abdominal pain and constipation. She was 
      diagnosed with a urinary tract infection (UTI) and treated with ceftriaxone. 
      During her hospitalization, she was administered opioid pain relievers and 
      underwent an intensive bowel regimen. Despite these measures, her constipation 
      and abdominal discomfort persisted, and magnetic resonance imaging (MRI) of the 
      abdomen revealed significant dilatation of the large bowel. The patient, 
      discovered to have hyponatremia, underwent further evaluation. This revealed 
      elevated urine osmolality and decreased blood plasma osmolality, indicative of a 
      syndrome of inappropriate antidiuretic hormone secretion (SIADH). The patient 
      received treatment with hypertonic saline. Later in her hospital stay, she tested 
      positive for CDI through stool analysis and was treated with oral vancomycin. 
      This case underscores the importance of considering CDI as a differential 
      diagnosis in cases of ileus, abdominal pain, and constipation, especially in 
      patients with notable risk factors for CDI. It highlights that the presence of 
      diarrhea or watery bowel movements is not a necessary symptom for CDI testing.
CI  - Copyright (c) 2024, Ismail et al.
FAU - Ismail, Mohamed
AU  - Ismail M
AD  - Department of Medicine, Rutgers University New Jersey Medical School, Newark, 
      USA.
FAU - Goyal, Ritik
AU  - Goyal R
AD  - Department of Medicine, Rutgers University New Jersey Medical School, Newark, 
      USA.
FAU - Elaskandrany, Menna-Allah A
AU  - Elaskandrany MA
AD  - Internal Medicine, Lenox Hill Hospital, Manhattan, USA.
FAU - Bebawy, Michael
AU  - Bebawy M
AD  - Department of Medicine, Rutgers University New Jersey Medical School, Newark, 
      USA.
FAU - Singh, Sahiba
AU  - Singh S
AD  - Medicine, College of Osteopathic Medicine, Michigan State University, East 
      Lansing, USA.
FAU - Ruane, Claire
AU  - Ruane C
AD  - Department of Internal Medicine and Pediatrics, Rutgers University New Jersey 
      Medical School, Newark, USA.
FAU - Wang, Weizheng
AU  - Wang W
AD  - Gastroenterology and Hepatology, Rutgers University New Jersey Medical School, 
      Newark, USA.
LA  - eng
PT  - Case Reports
DEP - 20240202
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10909384
OTO - NOTNLM
OT  - c diff
OT  - euvolemic hyponatremia
OT  - nonspecific abdominal pain
OT  - syndrome of inappropriate secretion of antidiuretic hormone (siadh)
OT  - young female with constipation
COIS- The authors have declared that no competing interests exist.
EDAT- 2024/03/04 06:44
MHDA- 2024/03/04 06:45
PMCR- 2024/02/02
CRDT- 2024/03/04 04:56
PHST- 2024/02/02 00:00 [accepted]
PHST- 2024/03/04 06:45 [medline]
PHST- 2024/03/04 06:44 [pubmed]
PHST- 2024/03/04 04:56 [entrez]
PHST- 2024/02/02 00:00 [pmc-release]
AID - 10.7759/cureus.53449 [doi]
PST - epublish
SO  - Cureus. 2024 Feb 2;16(2):e53449. doi: 10.7759/cureus.53449. eCollection 2024 Feb.